Inspection on 03/07/07 for 86 London Road

This inspection was carried out on 3rd July 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

86 London Road 19/07/06

86 London Road 27/10/05

86 London Road 04/06/05

86 London Road 01/02/05

86 London Road 05/08/04

86 London Road 30/03/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 London Road (86) 86 London Road Wickford Essex SS12 0AR Lead Inspector Carolyn Delaney Unannounced Inspection 3rd July 2007 12:00 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address London Road (86) DS0000018029.V339553.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. London Road (86) DS0000018029.V339553.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service London Road (86) Address 86 London Road Wickford Essex SS12 0AR 01268 562660 01268 562660 shclondonroad@estuary.co.uk Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Estuary Housing Association Limited Manager post vacant Care Home 4 Category(ies) of Learning disability (4) registration, with number of places London Road (86) DS0000018029.V339553.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th July 2006 Brief Description of the Service: 86 London Road offered care to four adults with learning disabilities. The house was detached and in a residential street near to Wickford town. There were four single bedrooms, one of which was on the ground floor. Residents have the use of a separate sitting and dining room. Upstairs there was a separate bathroom and a shower room. One room upstairs had been changed into a visitor’s room and a training room for staff. The garden was large, accessible and well maintained. The home had its own transport to facilitate access to the community for residents. The weekly fee for a place at the home is of £1,555. 54. London Road (86) DS0000018029.V339553.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine unannounced Key inspection carried out on 3rd July 2007. It took place over six and a half hours between 12.00 midday and 6.30 pm. As part of the inspection process each of the four people who live at the home were provided with an easy read version of the ‘Have your say about’ survey, which staff assisted residents to complete the areas where they could understand the questions and make a decision in respect of the choice of answers. However it is noted that this survey is not suitable for most of the people living at the home at the time of this inspection. In addition the relatives of three residents living at the home, the residents general practitioner and other health professionals who are involved in the care for residents were contacted by post and given the opportunity to make comment about the home. However at the time of writing this report none of those people contacted had responded. Records including assessments, care plans, daily care notes, and medication records and risk assessment documents in respect of a number of people living at the home were examined. However at the time of writing this report none of those people contacted had returned completed questionnaires. The homes manager, and three residents were were spoken with and a number of records including duty rotas and staff recruitment files were examined. A tour of the premises was carried out. Key standards as identified in the intended outcomes sections of this report are inspected at each key inspection. Key standards are identified for each section of the report. Where other standards have not been assessed these will have been assessed at previous inspections. Reports in respect of previous inspections may be accessed via the Commissions website www.csci.org.uk. The judgements made in this report are based upon the information collected during the site visit, the information provided by residents relatives and other relevant individuals, and other information received by the Commission from the home and other parties. Below is a brief summary of the findings of the inspection. More detail is contained within the main body of the report. London Road (86) DS0000018029.V339553.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? The homes manager has been employed at the home for a year and in that time there have been a number of improvements made. The way in which information about each person is recorded has been improved. Information about a persons needs and how staff are to support the person and the person’s wishes and preferences is recorded and reviewed regularly. The manager and the organisation have been looking at developing a pictorial format for policies and procedures, which affect the residents in the home. London Road (86) DS0000018029.V339553.R01.S.doc Version 5.2 Page 7 Staff receive the training and support they need including training in respect of invasive procedures associated with administering medicines. The homes manager regularly monitors and assesses staff practices in respect of administering medicines to residents. There is information available to show that the agency staff who work at the home have been recruited properly by the agency and that they have received training and are skilled in caring for young people with a variety of learning disabilities and complex behaviour. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. London Road (86) DS0000018029.V339553.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection London Road (86) DS0000018029.V339553.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4 & 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Information about the home is not currently provided in a format, which residents can understand, however staff ensure that residents are provided with relevant information through verbal communication and other means. The homes process for assessing people needs is thorough to ensure that home will be suitable for them and that the admission of new residents will not adversely affect the dynamics within the home. EVIDENCE: Estuary Housing Association Ltd have a format for the statement of purpose (which sets out the aims and objectives of the home). This document is in need of review and updating so as to include all of the information required including details if the fees for accommodation at the home and any other charges incurred for services or facilities not included in the cost of accommodation. The current format of both the statement of purpose and service users guide is not suited to the needs of residents. London Road (86) DS0000018029.V339553.R01.S.doc Version 5.2 Page 10 The homes registered manager said that Estuary were reviewing these documents with a view to providing pictorial references to aid residents understanding. However it is accepted that it may be difficult to develop a format, which would be suited to residents as they all have differing levels of comprehension and interpretation. Generally it appears that the people living at the home rely upon staff for information and support in finding out the routines etc within the home. One person had moved into the home since the last inspection. A comprehensive assessment of this person’s physical, mental and social needs had been carried out by the home manager with the input of other healthcare professionals who have been involved in the care of the person. The record of this assessment was detailed, clear and provided staff with clear and concise information about all aspects of the care and support that the person needs such as how the person likes to spend their time, how they interact with others and what support the person needs to be able to live a safe and fulfilling life. This resident had visited the home a total of six times including spending a night at the home, before they moved. Records were made regarding the experience of both the new resident and those already living at the home. These records indicated how the residents interacted with each other and the impact upon the dynamics within the home. At the time of this inspection the new resident had been living at the home for three months and staff were working with a behavioural team in order to assist and support the resident in settling into their new home. Each person living in the home has a contract and a license to occupy. These documents were examined. The contract included a photograph of the resident, details of the cost of placement including the contribution made by the resident. There was information in picture format as visual aids to describe some of the resident’s rights and responsibilities including the right to complain and the arrangements for review the persons care plan. The contract does not include specific details of charges. The manager had discussed the contract with the resident who had agreed and signed the contract. London Road (86) DS0000018029.V339553.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Information about each person’s specific needs is clearly recorded and kept under review. Residents are supported in making choices and taking risks as part of living their lives as independently as possible. EVIDENCE: The care plans and other information recorded for two people living at the home was assessed. The information recorded was detailed, concise and written clearly. Information about the resident’s abilities to carry out activities of daily living such as washing and dressing, preferences for meals and what activities they enjoy was recorded and was individual to each residents specific needs. There was recorded information regarding individual’s preferences about how they live where residents are able to express these wishes. For example it was recorded that one resident chooses to eat their meals alone rather that with other people living in the home. London Road (86) DS0000018029.V339553.R01.S.doc Version 5.2 Page 12 There were details of the individual’s choice in relation to how the person would wish to spend their free time for both the residents whose care plans were examined. There is a system in place for assessing risks to the health and safety of residents and managing these in a way, which allows residents to take risks. Assessments were in place in respect of the risks associated with activities such as swimming and access to the local community. The homes manager said that two residents occasionally like to prepare food and snacks and do so under the supervision of staff. London Road (86) DS0000018029.V339553.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 15, 16 & 17 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. More could be done so as to provide opportunities for occupation, activities and social engagement for some residents living at the home. EVIDENCE: At the time of this inspection none of the people living at the home were in paid or voluntary employment. Each of the four people have attended the local adult education college. One resident had completed courses in mixed craft and music and drama, and one resident had completed a course in mixed craft. These courses had finished at the time of this inspection and the homes manager said that they were looking into other opportunities for other college courses for residents. One resident goes out swimming once a week, two residents go out horse riding once a week and one of the two attend a local Salvation Army centre for gardening, I.T. and carpentry activities. In addition residents have the London Road (86) DS0000018029.V339553.R01.S.doc Version 5.2 Page 14 opportunity to go out to local pubs and clubs, library and shopping. Extra staff are employed to support residents in these activities. Estuary provided £300 per person towards an annual holiday. Other costs including the cost of staff to support the resident are payable by the person. At the time of this inspection one resident had spent a week with their parents and there were plans for the resident to go on ‘day trips’ out of the home. A holiday is planned for one resident to go to Centre Parks in November and there are plans for a weekend away for the newest resident dependent upon their progress in settling into the home and their ability and wish to travel. Residents in the home are supported and encouraged to eat a healthy diet. Staff support residents in shopping for food each week and there is evidence that residents have a choice as to what food they eat each day. Due to residents activities during the day they usually choose to have their main meal in the evening and have salad, sandwich or a hot lunch during the day. One resident has a tendency to eat ‘junk food’. Healthy alternative snacks are provided at regular intervals for this resident. Each persons weight is monitored on a regular basis. Residents chose to have a risotto for their evening meal and two residents said that they enjoyed their meal. At the last inspection it was noted that more opportunities for activities could be provided for residents and at this time it was not clear that this has happened and there does not appear that there are more activities or opportunities available than there were at the time of the last inspection. London Road (86) DS0000018029.V339553.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in the home are supported in a way that suits their needs and staff ensure that residents receive the medical and healthcare treatments, which they need. EVIDENCE: There care plans which were examined during the day of the inspection included details about the way in which the individual resident prefers to receive and be supported in personal care such as washing and dressing arrangements for personal grooming. For example it was recorded that one person prefers to bathe rather than shower. There was detailed information in both care plans, which were examined, about the care and support that both people need and how staff at the home were to support residents. London Road (86) DS0000018029.V339553.R01.S.doc Version 5.2 Page 16 There was a detailed plan of care for one person who has epilepsy, including detailed information as to how staff are to support the resident in the event of a seizure. Where there are risks to a person’s safety or welfare there were detailed plans in place as to how the risks were to be managed while supporting the person to live lives as independently as possible. Residents in the home are registered with a local G.P. and other health care professionals such as dentists, chiropodist etc. Staff support residents to attend appointments for routine check-ups and visits for treatment. One resident occasionally will refuse to attend G.P. appointments and the manager has arranged for the G.P. to make house calls where necessary. The G.P. with whom the residents at the home are registered was contacted and provided with a survey form. However they returned the form and said that they could not complete it, as they had not been to the home. There was information in residents files in respect of specialist medical & psychological tests and proposed / potential treatments. The people living in the home are not capable of safely keeping control of and safely administering medicines and rely on staff to ensure that they receive the medicines which are prescribed for them as part of their treatment. The home receives supplies of medication from BOOTS Pharmacy, which are checked by staff so as to ensure that the correct medicines in the correct amount are received and prompt action is taken if there are any discrepancies. The Medication Administration Records (MAR) for one person living at the home was sampled. There was evidence that staff administered the prescribed medicines at the appropriate times. There were detailed protocols in place for the medicines administered on an ‘as required’ basis which clearly state the reason for the use of the medication. All staff working in the home have received training in respect of the administration and the staff training plan evidenced that updates for this training are planned. In addition to this the homes manager assesses the competency of staff periodically. London Road (86) DS0000018029.V339553.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at the home are supported as far as possible to be able to make complaints should they be unhappy. There are procedures in place so as to protect people living in the home from abuse, neglect and harm. EVIDENCE: The home has a procedure for dealing with complaints. Complainants will receive an initial response to their complaints within 10 days and Estuary aim to complete their investigations into any complaints and respond within twenty-eight days The homes manager has devised a pictorial format for residents so as to explain how they could make a complaint. However due to the levels of residents comprehension it is not clear that residents would fully understand or that they would retain the information for any period of time. Residents care plans include specific information about their likes and dislikes and staff working at the home know the residents needs and how to act and support them so as to minimise the need for residents to complain. The home has received two complaints since the last key inspection. A neighbour made both complaints. One complaint was made in September 2006 regarding the pruning of a tree close to the border between both properties. This complaint was dealt with in accordance with the homes procedure. The second complaint was made in July 2007 about the noise level caused by a resident who ‘bangs radiators’ and shouts loudly on occasions. This complaint London Road (86) DS0000018029.V339553.R01.S.doc Version 5.2 Page 18 was being dealt with at the time of the inspection and the homes manager had visited the neighbour and provided them with a complaint form, which had then been sent to the head office as per the homes policy. There have been no complaints made to the home or CSCI in respect of the care or services provided by the home. All staff working at the home including temporary agency staff have undertaken training in respect of the protection of vulnerable people from harm, abuse or neglect. In addition staff have been provided with the Essex Vulnerable Adults Protection Committee guidelines. The homes manager has attempted to provide an easy read pictorial format so as to explain to residents how they can expect to be treated and what to do if they experience inappropriate treatment. However many of the residents are not capable of understanding or retaining this information. As part of each individual care plan there is a plan for supporting residents to budget and manage money effectively. Each resident has a bank savings account, which attracts the current rate of interest. These accounts appear to be managed by Estuary Housing Association Ltd. A float of approximately £200 is kept at the home from which residents can access up to £50 per week for small purchases such as toiletries etc. A record of all transactions is made in respect of each resident and there are receipts available to as evidence of resident’s purchases. Each week the homes manager checks and reconciles these records and sends records and receipts to the head office and a cheque is raised for the amount spent. The homes manager said that if more funds were needed that an order for the increase would be raised at the end of the week and the money would be provided the following week. This practice does not allow residents full choice in access to their money, however it is not clear that residents would have the capacity to manage money safely if they had access to it. There should be more clarity as to the arrangements for managing residents monies and how people can access their money should they choose to. There have been some concerns raised in the past about how resident’s monies are used and any additional costs that the residents incur at the home. It was identified at the last inspection that some residents regularly go out for lunch and that they pay for this. The contract of terms and conditions state that the provision of food is included within the cost of placement. Residents have a ‘take away’ meal one evening each week and this is paid for out of the homes food budget. Some residents choose to go out once a week to have a pub lunch for which they pay for out of their own monies. London Road (86) DS0000018029.V339553.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is clean, comfortable and furnished to suit the people who live there. EVIDENCE: Each resident living at the home has their own bedroom, which are personalised according to the wishes of the resident. The communal areas, including lounge, dining room and kitchen were furnished and equipped in a manner, which suits the needs of the people who live in the home. Furniture is comfortable and the décor provides a homely and ‘lived in’ feel to the home. There was evidence that where repairs and renovation to the homes environment that these were carried out promptly. The homes manager was advised that some areas of carpeting in the home was showing signs of wear and was stained in a number of areas. London Road (86) DS0000018029.V339553.R01.S.doc Version 5.2 Page 20 Residents have access to a well-maintained garden area. London Road (86) DS0000018029.V339553.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35 & 36 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The practices for recruiting, training and deploying staff at the home are good, however the staffing levels for night duty need to be reviewed to ensure that they are appropriate for the needs of residents. EVIDENCE: Staff who are employed to work at the home are provided with a description of the role of the support worker, the expectations and responsibilities involved. Since the last inspection the homes manager has devised a system for allocating specific duties relating arranging activities both within and outside of the home for residents. This process has given staff a sense of responsibility and accountability for supporting residents in this way. From the duty rotas examined for the previous two months it was evident that the minimum staffing levels of two staff during the day and one during the night were being maintained. In addition staff worked extra hours to support residents to access activities in the community where one to one or two to one staff to resident ratio was required. London Road (86) DS0000018029.V339553.R01.S.doc Version 5.2 Page 22 Staff tend to work twelve-hour shift patterns and this suits the needs of residents as they benefit from continuity of care and support. All staff working at the home have a minimum of one off duty day per week and rotas examined indicate that staff usually have two off duty days per week. The newly admitted resident has complex behavioural needs and it was not clear that staffing levels, particularly for the night duty are appropriate and sufficient to care and support all residents safely. Permanent staff working at the home are supported by staff from a local employment agency. The manager said that the home uses approximately 137 hours of agency staff per week. The agency staff used are usually a core team who know the residents and understand their needs. This ensures continuity of care and support and minimises the stress to residents and staff. However on the day of the inspection the manager was supported by two agency staff (to cover for annual leave) and while these staff were observed to support residents with care needs and to prepare and serve meals they were not observed to spend other times engaging and interacting with residents and on a number of occasions the two agency staff on duty were observed to be sitting in the kitchen chatting and reading magazines rather than spending time encouraging and supporting residents. The agency provides a profile, which includes a photograph and details of the checks undertaken in respect of the staff supplied to the home such as details of the Criminal Records Bureau (CRB) disclosure carried out. In addition the agency provides details of the training which staff have undertaken including moving and handling, and training in respect of protecting vulnerable people from abuse. Agency staff who work at the home are provided with an induction when they first commence work at the home. All staff working at the home receive training for first aid, PoVA, Manual Handling, Administration of medicines, management of epilepsy, health & safety, food hygiene and risk assessment. The homes manager assesses when staff training updates are due and requests training sessions through the organisations human resources department and this was evidenced in the draft staff training plan. The home employs a total of seven full time support workers and the homes manager. There have been no staff recruited to work at the home since the last inspection, however two staff have moved from Heath Close (an Estuary home in Billericay). There was evidence that these staff undertook a period of induction to familiarise themselves with the home and the needs of the residents. Five of the seven staff working at the home have received supervision and there is a plan in place for the regular supervision of all staff. London Road (86) DS0000018029.V339553.R01.S.doc Version 5.2 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 & 43 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed and there have been a number of improvements made over the past twelve months, which benefit the people who live there. EVIDENCE: At the time of the last inspection a new acting manager had been appointed to work at the home. At the time of this inspection this person was nearing the end of the process for being registered as the homes manager. There was evidence of many improvements made in the home during the past twelve months. The manager acknowledged that there was more to achieve and assured the inspector that he would continue to improve and maintain standards in all aspects of the home. London Road (86) DS0000018029.V339553.R01.S.doc Version 5.2 Page 24 The homes manager said that Estuary were developing a pictorial questionnaire so as to obtain the views of residents about the home. However at the time of this inspection there was no evidence that the home had a system in place for monitoring, maintaining and improving the quality of the services provided based upon the views of those people who live in the home. Records were available in respect of the checks, which are carried out routinely in the home so as to ensure that residents live in a safe environment. The issues identified at the last inspection, regarding the storage of items considered hazardous to health including cleaning products, had been addressed and all chemical cleaning agents and toiletries are stored securely. Regular checks are carried out in respect of the equipment and systems for detecting and managing any outbreak of fire in the home such as fire alarms, emergency lighting, fire extinguishers and fire door closure systems. Staff participate in regular fire drill exercises. As it is not appropriate for fire drill exercises to be carried out at night, as it would upset residents unduly the manager has devised a system for assessing the understanding/ competency of staff who work at night by creating scenario based questionnaires which staff complete. Following a visit to the home by the Essex Fire Authority where it was noted that the home did not have a fire risk assessment in place, this has been carried out and a copy of the document is available in the home. Checks are carried out to ensure that hot water is delivered at a temperature, which prevents the risk of scalds to residents. Throughout the inspection there were no concerns or issues raised about the safety of the homes environment. London Road (86) DS0000018029.V339553.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 2 4 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 3 32 2 33 2 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 X 3 3 X LIFESTYLES Standard No Score 11 3 12 2 13 2 14 2 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 2 X X 3 3 London Road (86) DS0000018029.V339553.R01.S.doc Version 5.2 Page 26 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA1 Regulation 4& schedule 1. Requirement The homes statement of purpose must be updated so that it includes all of the elements as required by Regulation including details of fees and any other charges incurred for services provided by the home. Where temporary staff are used measures should be implemented to ensure that the level of support and engagement with residents is not compromised. Staff must be employed in sufficient numbers to meeting the changing needs of people living in the home. This is in particular reference to the staffing levels at night and the needs of the person who has most recently moved into the home. Monthly inspections of the home are undertaken in accordance with Regulation 28 of the Care Homes Regulations 2001 and copies of these are sent to the Commission as required by DS0000018029.V339553.R01.S.doc Timescale for action 30/09/07 2. YA32 18(1) (b) 30/09/07 3. YA33 18(1) (a) 10/09/09 4. YA39 26 19/10/07 London Road (86) Version 5.2 Page 27 Regulation. (Previous timescale of 01/07/05 and a 01/11/05 not met) This standard was not assessed on this occasion. 5. YA39 24 A system must be implemented for regularly monitoring, maintaining and where necessary improving the quality of care and services provided by the home. This must include the views of residents an / or their relatives and any other stakeholders including health & social care professionals. This requirement is outstanding from the previous inspection and the previous timescale of 19/10/06 has not been met. 19/10/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard YA24 YA32 Good Practice Recommendations Carpets should be replaced as part of the homes maintenance and redecoration programme. At least 50 per cent of care staff should achieve NVQ training. London Road (86) DS0000018029.V339553.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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